Essentially taking
an active role in your healing ('approach coping') is better than
taking a passive role or avoiding the problem. Approach/tackle coping
means learning about your condition (be it PTSD or other), learning
coping skills and seeking social support. Things not to do are going
into denial, self blame and partying too hard. Those are called avoidance
coping and they keep you from healing more quickly. (Bloks
et al., 2004)

Other helpful
things that researchers recommend are activities such as moderate
exercise, information seeking and relaxation. (Broder,
1996)

"Here’s
the 54321 “game.” NOTE: If this doesn’t work to
bring someone up out of a dissociative state, that’s okay. The
key is also distraction. if you or someone you’re helping, looks
around the room enough, sometimes that is enough to bring someone
back into the present. If not, well then at least it can keep someone
distracted if they are feeling like self-injuring.

Name 5
things you can see in the room with you.

Name 4
things you can feel (“chair on my back” or “feet
on floor”)

Name 3 things
you can hear right now (“fingers tapping on keyboard”
or “tv”)

Name 2 things
you can smell right now (or, 2 things you like the smell of)

Name 1 good
thing about yourself."

and

Containment

"After
you’ve done your meditation and breathing exercises, you can
visualize a “safe place.” Whatever safe place is special
to you. For me, it’s a local park where we go on picnics and
feed a cat and some ducks. I visualize myself in the park, all alone.
Then I visualize a “container.” For me, this is usually
a purple box. I imagine that I am putting the memories, or whatever
was causing me mental pain at the time, into the box."

Keep your
image of your safe place so you can come back to it when you need
to.

Make a relaxation
tape of your safe place (This can be combined with breath."

"Needs
are met by three Resource ego states, a Nurturing Adult Self, a Protective
Adult Self, and a Spiritual Core Self. These Resources assume a competent
caregiver role... together these three Resources form a wonderful
container called a Healing Circle. Wounded child parts are invited
inside the circle, and asked what they need most now. The Resources
are able to meet that need. Then they are asked what else is needed
and the Resources meet that need too. " What
is EMDR? Developmental Needs Meeting Strategy

"Anxiety
management involves learning several skills that will help you cope
better with PTSD symptoms...Some people use anxiety management techniques
to help control anxiety while they do exposure therapy. Five different
techniques for anxiety management are:

"EMDR,
or eye movement desensitization and reprocessing, is a new, nontraditional,
very short-term therapy for treating trauma victims that utilizes
rhythmical stimulation such as eye movements or hand taps"

"Table 1. CSE scale: standardized exploratory factor analysis (EFA) and confirmatory factor analysis
(CFA) loadings
Study 1 Study 2
Factor EFA CFA CFA
Use problem-focused coping
Break an upsetting problem down into smaller parts .89 .87 .83
Sort out what can be changed, and what cannot be changed .86 .80 .75
Make a plan of action and follow it when confronted with a problem .85 .85 .80
Leave options open when things get stressful .80 .77 .82
Think about one part of the problem at a time .71 .78 .79
Find solutions to your most difficult problems .68 .78 .75
Resist the impulse to act hastily when under pressurise .61 – –
Try other solutions to your problems if your first solutions don’t work .54 – –
Talk positively to yourself .49 – –
Stand your ground and fight for what you want .48 – –
See things from other person’s point of view during a heated argument .46 – –
Develop new hobbies or recreations .29 – –
Stop unpleasant emotions and thoughts
Make unpleasant thoughts go away .97 .91 .88
Take your mind off unpleasant thoughts .89 .81 .80
Stop yourself from being upset by unpleasant thoughts .86 .89 .91
Keep from feeling sad .73 .78 .82
Keep from getting down in the dumps .55 – –
Look for something good in a negative situation .52 – –
Keep yourself from feeling lonely .44 – –
Visualize a pleasant activity or place .36 – –
Pray or meditate .29 – –
Get support from friends and family
Get friends to help you with the things you need .94 .95 .92
Get emotional support from friends and family .76 .73 .79
Make new friends .58 .63 .63
Do something positive for yourself when you are feeling discouraged .42 – –
Get emotional support from community organizations or resources .22 – –"

"The
coping strategies that a victim of a rape engages in can have a strong
impact on the development and persistence of psychological symptoms.
Research provides evidence that victims who rely heavily on avoidance
strategies, such as suppression, are less likely to recover successfully
than those who rely less heavily on these strategies. The present
study utilized structural path analysis to identify predictors of
avoidance coping following rape and examined factors in the assault
itself (e.g., force, alcohol use), sequelae of the assault (e.g.,
self-blame, loss of self-worth), and social support as potential direct
and indirect predictors of avoidance coping. From a sample of 1,253
university women, the responses of 216 women who endorsed an experience
of rape were examined. Results suggested that sequelae of the assault
such as feelings of self-blame and negative reactions received from
others are potentially important predictors of avoidance coping. Implications
of the results for future rape recovery research are discussed."

"Research
provides evidence that victims who rely heavily on avoidance strategies,
such as suppression, are less likely to recover successfully than
those who rely less heavily on these strategies. The present study
utilized structural path analysis to identify predictors of avoidance
coping following rape and examined factors in the assault itself (e.g.,
force, alcohol use), sequelae of the assault (e.g., self-blame, loss
of self-worth), and social support as potential direct and indirect
predictors of avoidance coping. "

"Past
control (behavioral self-blame) was associated with more distress
partly because it was associated with greater social withdrawal. Present
control (control over the recovery process) was associated with less
distress partly because it was associated with less social withdrawal
and more cognitive restructuring."

"Describes
the development and psychometric characteristics of the Coping Responses
Inventory (CRI), which assesses eight types of approach and avoidance
coping responses among adults and youth. To illustrate some of the
research applications of measuring coping responses, findings from
longitudinal studies of adaptation among distressed and healthy individuals
and two case reports (a 23-yr-old female in an abusive relationship
and a 16-yr-old with an unplanned pregnancy) are reviewed. One relatively
consistent finding is that individuals who rely more on approach and
less on avoidance coping tend to experience better health and well-being.
Applications of the work for clinicians and program evaluators are
noted and issues for future research on stress and coping theory are
considered."

"The
present study hypothesized that the effect of coping on the relationship
between life events (stressors) and psychological symptoms (distress)
in adolescence depends on the type of coping skills used, specifically
that avoidance coping skills mediate, and approach coping skills buffer
or moderate, this relationship. As part of a large community-based
prevention trial, a random sample of 9th, 10th and 11th grade students
was administered a self-report survey that included life events, coping
strategies, and psychological symptoms (anxiety, depression, and somatic
complaints). Using baseline and one year follow-up data, longitudinal
single and multiple group structural equation models were used to
evaluate mediating and moderating effects of different coping strategies.
Results supported the hypothesis that adolescent use of avoidance
coping strategies of antisocial behavior, "partying" behavior,
and substance use mediates the effect of stressors on increased psychological
symptoms. The results also supported a stress-buffering effect of
the use of high levels of approach coping strategies of exercise,
information seeking, and relaxation. High levels of approach coping
protect against the negative effects of stressful life events on psychological
symptoms. Some gender and age-specific differences in levels of stressors
and distress were observed. Females reported more stressful life events
and more psychological symptoms or distress than males. Older students
reported more stressful life events than younger students. The hypothesized
results would suggest that prevention programs aimed at decreasing
risk for mental illness, drug abuse, and problem behaviors in adolescents
should emphasize both decreasing the use of avoidance coping strategies
and increasing the use of approach coping strategies."

"Presents
a bibliography of articles on recovery and healing from sexual abuse.
"The Me Nobody Knows: A Guide for Teen Survivors"; "Outgrowing
the Pain Together: Partners, Friends, and Families of Abuse Victims";
"Outgrowing the Pain"; "Someone in My Family Molested
Children"; "That's Never Been Told: Healing the Wounds of
Childhood Sexual Abuse"; "How Long Does It Hurt? A Guide
to Recovering From Incest and Sexual Abuse for Teenagers, Their Friend,
and Their Families"."

"Reviews the
literature on the theories and treatment of sexual assault victims.
Crisis theory and intervention are addressed, followed by a discussion
of cognitive and behavioral treatments for posttraumatic stress disorder
(PTSD), depression, and sexual dysfunctions. Treatments considered
include exposure techniques, coping skills packages, and cognitive
therapy. A description of information processing theory is included."
PsycINFO Database

"This study compared the efficacy of an Internet-based, 8-week
self-help program for traumatic event-related consequences (SHTC)
(n = 13) to a wait-list (WL) condition (n = 14). The SHTC consisted
of cognitive–behavioral modules that progressed from the least
anxiety-provoking component (i.e., information) to the most anxiety-provoking
(i.e., exposure). Participants were those who had experienced a traumatic
event and had been experiencing subclinical levels of symptoms associated
with the event. Participants mastered the material in each module
before proceeding to the next module. Pre- and post-treatment assessments
revealed that SHTC participants decreased avoidance behavior, frequency
of intrusive symptoms, state anxiety, and depressive symptoms, and
increased coping skills and coping self-efficacy significantly more
than WL participants. SHTC participants demonstrated more clinically
significant improvement than WL individuals."

"The purpose
of this study was to obtain empirical evidence of the effects of a
stress management programme on undergraduate Pharmacy and Biochemistry
students. As a first stage, we evaluated beliefs, academic skills
and personal stress involvement problems in 136 students. As a second
stage, we designed a stress management pilot programme (SMPP) including
psycho-educational resources; coping skills training; deep breathing,
relaxation and guided imaginary techniques; cognitive restructuring
and time management. To evaluate the effects of the SMPP on students
we assessed a set of variables before and after the treatment: Anxiety,
anger, stress, coping strategies, helplessness, salivary cortisol
and psycho-physiological reactivity levels. Towards the end of their
SMPP exposure, students had lower levels of stress, anxiety, anger,
neuroticism, helplessness and salivary cortisol. These results suggest
that SMPP has a promising applicability to deal with high levels of
stress, improving the students academic performance and health."

"This paper
presents a model of coping that intersects the emotion and social
dimensions of depression. It demonstrates the dynamic socio-emotion
interplay and modulation of affect in response to our environment,
specifically in relationship to others. Humans can be socially disconnected
but emotionally repleted, or socially connected but emotionally depleted,
but those who are depressed are more likely to be socially disconnected
and emotionally depleted. Conversely, those who are socially connected
and emotionally repleted are more likely to employ adaptive coping
skills to alleviate emotional distress. When applied to counselling
sessions, the model helps to explain client and counsellor dissatisfaction
with the process and outcome of the interaction. The model is designed
to increase awareness of emotion regulation and to enhance coping
skills by offering a practical approach to managing socio-emotion
response to the vicissitudes of life."

"Clinical
features, epidemiology and aetiology of post-traumatic stress disorder
(PTSD) are outlined. Treatment outcome studies involving children
with PTSD who have survived traumatic accidents, natural disasters
and child sexual abuse are reviewed. An evidence-based assessment
and treatment protocol is outlined for children and adolescents with
PTSD. Key components of effective treatment are psycho-education about
trauma reactions, sustained exposure to trauma-related cues and memories
until habituation occurs, coping skills training for children to help
them manage anxiety and parent training to equip parents with the
skills to help them facilitate their children's recovery."

"The clinical
disciplines have witnessed a rapidly growing literature on the conceptualization
and measurement of coping and on the role of coping in confronting
stressful life circumstances and maintaining adaptive functioning.
This literature has spawned a diversity of concepts and contrasting
perspectives on the determinants and effects of coping. To address
this complexity, we comment on dispositional and contextual perspectives
on the coping process, describe the domains of coping styles and coping
skills, and review some measures of these constructs. Next, we present
a conceptual framework that integrates key aspects of these constructs
and use the framework to guide a selective review of the linkages
between personal and social resources, coping skills, and adaptive
functioning. We then consider applications of the framework to clinical
practice."

"This study
evaluates the different types of childhood trauma, avoidance coping,
and patterns of drug and alcohol use among 112 alcohol and drug abusing
females in outpatient and residential treatment. A passive research
design with self-report surveys was administered to female participants
during treatment to assess the relationship between childhood trauma,
coping methods, and alcohol and drug use. A multiple regression analysis
demonstrated that women with a history of emotional abuse were more
likely to engage in avoidance coping skills than those without a history
of emotional abuse, which provides some support for the theory
that alcohol and drug abuse may be an avoidance coping method for
childhood trauma."

"This paper
proposes the development of a new model of treatment for survivors
of sexual abuse suffering from Posttraumatic Stress Disorder (PTSD).
Foa, Rothbaum, Riggs, and Murdock (1991) and Foa, Rothbaum, and Furr
(2003) support Prolonged Exposure (PE) as a highly effective treatment
for PTSD. However, PE can be intimidating to survivors, contributing
to hesitancy to participate in the treatment. This paper posits that
animal-assisted therapy (AAT) will decrease anxiety, lower physiological
arousal, enhance the therapeutic alliance, and promote social lubrication.
The paper also posits that AAT will enhance the value of PE by making
it more accessible to survivors, increasing social interaction, and
perhaps decreasing the number of sessions required for habituation
to the traumatic memories."

"Several
types of therapy may be useful and they are often combined in a multi-faceted
approach to understand and treat this condition.

-Cognitive-behavioral
therapy focuses on changing specific actions and thoughts through
repetitive review of traumatic events, identification of negative
behaviors and thoughts, and stress management.
- Group therapy has been useful in decreasing psychological distress,
depression, and anxiety in some PTSD sufferers such as sexually abused
women and war veterans.
- Psychological debriefing has been widely used to treat victims of
natural disasters and other traumatic events such as bombings and
workplace shootings, however, recent research shows that psychological
debriefing may increase the stress response. Since this type of debriefing
focuses on the emotional response of the survivor, it is not recommended
for individuals experiencing an extreme level of grief.

Chibbaro, J. S.,
Jackson, C. M. (2006). Helping Students Cope in an Age of Terrorism:
Strategies for School Counselors. Professional School Counseling,
9 (4), p314-321.

"That
educators can foster the development of coping skills in young children
through heightened sensory awareness, positive expectations, a clear
understanding of one's strengths relating to accomplishment, and developing
a sense of humor. Taking action is among the coping skills helpful
to strengthen students' sense of self-control. Sklare (1997) wrote,
"Getting clients to take action first shows them that they are
able to succeed regardless of previous obstacles" (p. 14). Action
and movement help overcome a feeling of helplessness that often arises
from fear."

"Adaptive
coping, as measured on the Coping Scale for Adults, increased significantly
immediately following intervention. However, no significant changes
in anxiety, depression, self-esteem and psychosocial function were
observed on the measures used. Conclusions : The results suggest that
it may be possible to modify coping strategy use following brain injury,
through CBT."

"Results
indicated that older adult victims assigned to the video condition
and assessed later that day exhibited greater awareness of crime-related
symptoms, healthy coping strategies, and safely planning strategies
than did the older adult victims assigned to standard practice of
care. However, despite knowledge gains, and in contrast to our predictions,
no differences on measures of anxiety or depression were evident"

"Recovery
is associated with less Avoiding, less Passive Reacting, more Active
Tackling, and more Seeking of Social Support. Passive Reacting emerged
as a robust predictor of recovery. Seeking Social Support predicted
bulimic symptomatology and global functioning. Building coping skills
in eating disorder patients may start early in treatment and may make
patients less vulnerable for relapse."

"Based on
her own experiences, the author discusses how four major life challenges--health,
relationships, self-worth, and abundance--are linked to the consciousness
of being a victim, which can lead to a cycle of self-judgment and
the abuse of one's self and others; guidance is given on how this
state of mind can be transformed into self-love and spiritual empowerment.
The author speaks out of her own experiences of abuse, including a
violent date rape, multiple incidents of domestic abuse...She outlines
five steps for this escape. First, commit yourself to removing the
dominant self-consciousness of being a victim. Second, make a commitment
to use the tools offered in this book for beginning and maintaining
a plan of action. Third, say "no" to old negative thoughts
from yourself or others that have for so long determined how you feel
about yourself. Fourth, be aware of and catch yourself when you start
talking negatively about yourself. Finally, surround yourself with
others who want you to succeed in developing a new sense of self and
will join you in the journey not only to help you but also them."

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